Beyond the Contract: Managing Your Relationship with a Healthcare Payer

Softbound Book + companion CD-ROM
ISBN 1578398924
978-1578398928
HCPro Inc
November 2006
(click button below for the very best currently available price for this important resource)

Don’t be intimidated by the thought of negotiating managed care contracts.

Beyond the Contract is a hands-on survival guide that helps you prepare for negotiating sessions by delivering techniques and strategies you need so your organization comes out of contract talks on the winning end. Learn how to go further to protect your revenue under the contract terms that you have negotiated. When the working relationship between the plan and the health care provider functions well, you save time, staff resources and headaches. By monitoring and insisting on your rights at every turn, you also create an incentive for how you expect, and need, the plan to behave.

The accompanying CD-ROM comes with examples of contract clauses, model contracts, and relevant sample language you can download and customize for your organization, and a multi-page checklist for negotiation success. Each of these tools will be a valuable addition to your contract negotiations toolkit.

Negotiating contracts for managed care reimbursement is a significant challenge for healthcare providers. Even if you have experience at the negotiating table, it can be tough to get the terms and payment your organization deserves for the care it provides.

Beyond the Contract draws on a variety of articles, tools, and advice from sources who are experts at managing relationships between plans and providers. You’ll benefit from their experience by learning how to recognize issues you face in your daily operations and scenarios you’ll encounter at the negotiating table. You’ll learn how to make sound decisions and take proactive steps to respond to - and manage - the plan.

Learn how to get the terms and payment your organization deserves. Who is in charge of your managed care contract? You or the plan? Many books focus on the contents of the managed care contract. While the terms in the contract document are very important to the quality of your relationship with a managed care plan, they are only part of the story. You need to be able to manage your relationship with the plan on a day-to-day basis and have a contract that allows it. Ask yourself these three questions:

How do you effectively communicate with the plan to prevent little issues from growing into large, expensive ones?
How do you command the plan’s attention and get them to respond in a timely way?
How do you avoid re-submitting your complaint or dialing from person to person trying to get answers?

Beyond the Contract is a must-have resource for:

Managed care directors
PFS managers
CFO’s and VP’s of finance
Medical group administrators

This is a great resource for everyone responsible for setting up and monitoring managed care contracts.

With more than 17 years of experience, HCPro, Inc. is a leading provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance. The company's mission is to meet the specialized informational, advisory, and educational needs of the healthcare industry. As an acknowledged industry authority in healthcare regulation and compliance, HCPro focuses on providing its clients assistance and expertise in the areas of accreditation, medical staff affairs, credentialing, privileging, medical record management, regulatory compliance, nursing, quality/patient safety, infection control, and workplace safety.

(information from the publisher)

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